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Standardised Medications Reviews for Frail Older Patients: Driving Change through Digital Documentation and Data

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Alison McCulloch1, Karen Lowdon1
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Background Frail older patients are at increased risk of adverse drug events due to polypharmacy and age-related pharmacokinetic changes. Standardised Medication Reviews (SMRs) are essential for optimising prescribing, reducing harm, and improving outcomes as part of comprehensive in-patient geriatric assessments. However, both inconsistent documentation and data capture limit their effectiveness. The implementation of an electronic prescribing platform within our organisation enables real-time SMR documentation and creates opportunities for service improvement. Methods In alignment with

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Bridging the Gap: A Multi-Disciplinary Community Café Connecting Afro-Caribbean Communities to Dementia Research

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Sittana Abdelmagid1, Moira Rowan2, Bianca Fritsch2, Molly Khosla2, Joana Teixeira1, Pauline Dawkins3, Georgina Silva Fortes1
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Background: In 2024, 3.5% of patients reviewed in Dementia CNS clinics at St George’s Hospital, South-West London, identified as African or Afro-Caribbean according to audit data, despite the census recording the local population of these groups as over 10%. This underrepresentation is more concerning given national findings indicate that dementia rates are 22% higher among Black individuals in the UK compared to White counterparts. The disparity highlights systemic barriers to diagnosis, care, and research; emphasising the urgent need for culturally tailored outreach strategies. The aim of

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Improving Measurement of Lying and Standing Blood Pressure in Elderly Patients Presenting with Falls.

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Kehinde Taiwo, Diane Brisbane, Amy Wass
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Introduction Orthostatic hypotension, a fall in blood pressure (systolic drop >20mmHg, diastolic drop of 10mmHg) on standing up from lying or sitting position, is an important risk factor for fall among elderly population. In this quality improvement project, we assess the proportion of eligible patients who had lying and standing BP measurement. We made some interventions to improve this rate and reassess the proportion of patients who had their lying and standing pressure done afterwards. Method This is a prospective quality improvement project that recruited patients older than 65 years old
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How to capture valuable information on an Acute Frailty Unit- a Quality Improvement Project

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Dr R.Monteith, Dr A.Burgess, Dr E.Okorie
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Introduction: A midday board round was introduced on 19 bedded frailty unit to allow the multi-disciplinary team (MDT) to discuss each patient. The information shared verbally allowed us to learn about our patients, and, to facilitate a comprehensive geriatric assessment. However this information was not being captured within the medical notes. This was sub-optimal, it meant these details were subject to uncertainty later in the day, resulting in possible repetition of work or could even compromise patient care. Method: A sticker was developed, we were cognisant that this should not add
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Exploration Of Meaningful Activities For Older Adults In Acute Hospital: A Scoping Review

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Lyndsey Dunn1, Professor Karen Watchman2.
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Background: The global population of people aged 65 years and over is expected to rise from 761 million in 2021 to 1.6 billion by 2050. Many of these older adults have multiple comorbidities and functional impairments that make them particularly vulnerable during acute hospitalisation. Engagement in meaningful activities can be vital to older people’s care, particularly in acute hospitals. Evidence suggests that such engagement can have a positive impact on the patients’ hospital journeys. To ensure individualised support, it is important to understand the purpose of meaningful activities for

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Differences between younger (≤80 years) and older (>80 years) patients with Heart Failure with Preserved Ejection Fraction

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S Odigbo1; Y Millerick2,3; A Anand2; S Bagnall1; KJM Brooksbank1; C Corson2; R Davison1; V Dempsey2; P Fergusson1; K Gray2; A Lees2,3; Y Philipson2; J Stirton2; MC Petrie2,4; KJ Hogg2; MMY Lee2,4; J Taylor2; on behalf of Glasgow Royal Infirmary HFpEF team
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Introduction To describe differences in the baseline characteristics of two distinct patient groups, ≤80 years and >80 years enrolled the North Glasgow Heart Failure with Preserved Ejection fraction ( HFpEF ) pilot project, a joint working project with Boehringer Ingelheim. Method This is a quality improvement/equity of access project to develop a blueprint of care using a multidisciplinary team approach to manage HFpEF. Following comprehensive clinical assessment, patient data was entered onto a database (Castor) and analysed, stratifying patients by age (≤80 vs >80 years). Results From 14th

Standardising Rockwood Clinical Frailty Score Into Community Rehabilitation Assessments

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Niamh Breslin1, Laura Clinton1, Chris Grant-Pantry1
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Introduction Ageing & Frailty Standards(1) highlights the importance of identifying frailty at the earliest opportunity. A Community Rehabilitation Service is in prime position to incorporate frailty screening into the electronic healthcare record (EHCR). Clinical Frailty Scale (CFS)(2) is appropriate for this population however was not prompted within the assessment and as a result completion rates were low. The aim was to include the CFS Systematized Nomenclature of Medicines - Clinical Terms (SNOMED-CT) code in the template for all people aged over 65 and monitor completion rates. Methods

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Investigating the Impact of Anticholinergics on Memory Clinic

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Efan Fairclough1, Biju Mohamed2, Cherry Shute2
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Key words: Anticholinergic burden, memory clinic, dementia, polypharmacy Introduction The aging UK population and increases in life expectancy are contributing to an increase in the prevalence of dementia. A high anticholinergic burden (ACB) is associated with adverse prognosis in dementia. The aim of this service evaluation was to assess the prevalence of anticholinergic medications on referral to memory clinics in Cardiff and Vale memory assessment service. Methods A retrospective cross-sectional study was conducted which evaluated the referral letters of 200 new patients referred to memory
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Improving Delirium Detection in Older Inpatients: A Quality Improvement Project on 4AT Tool Utilisation

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Sheyaam Sahadevan
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Introduction Delirium is an acute or subacute neuropsychiatric syndrome characterized by disturbed consciousness, attention, and cognition. It is common among hospitalized older adults and is often underdiagnosed, which can negatively affect patient outcomes. The 4AT tool is a rapid screening instrument for delirium, particularly suited for ward-based assessments. This Quality Improvement Project (QIP) aimed to evaluate the use of the 4AT score in diagnosing delirium in inpatients and to raise awareness among healthcare providers to improve its usage. Method A retrospective analysis was
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Think Delirium: A Quality Improvement Project

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Euan McIntyre1 ESY Lau2 Joshua Jones3 Caroline Veitch4
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Introduction Delirium affects up to 50% of older patients (aged over 65 years) in hospital and is associated with serious consequences including greater morbidity and mortality, longer hospital stays with consequent hospital acquired complications, and an increased likelihood of hospital readmission. Early recognition prompting effective management is critical in improving outcomes for patients with delirium.  Methods  This QIP was conducted amongst Foundation Year 1 doctors (FY1) working across all wards in a busy district general hospital to improve knowledge of delirium through educational

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Development and Implementation of a Mini Comprehensive Geriatric Assessment (Mini-CGA) for the Community Resource Team, Newport

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Vaishnav Prakash; Shemir Sha Salim; Naman Arora; Kavan Arora; Kathryn Davis
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Background Comprehensive Geriatric Assessment (CGA) is the gold standard for evaluating frailty and complex needs in older adults. However, a full CGA can take up to two hours to complete- an invaluable but time-intensive process. The Community Resource Team (CRT) at St Woolos Hospital, Newport, delivers swift medical and nursing assessments to acutely unwell elderly and frail patients in their homes to prevent unnecessary hospital admissions as a part of the Gwent Frailty Unit Teams. For many patients seen by CRT, a full CGA may not be required and a shorter, streamlined assessment preserving
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Examining inequalities and inequities across sex in hip fracture care in Cardiff

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M James1; A Johansen1.
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Background Hip fractures are a common fragility fracture in older people; more than 4,000 patients with a hip fracture in Wales were submitted to the National Hip Fracture Database in 2024. Survival rates have improved in recent years, however while women are twice as likely to sustain a hip fracture than men, the risk of dying is greater for men who sustain a hip fracture. Methods We conducted a retrospective comparison of the demographics, care received and outcomes across sex in patients with hip fracture in Cardiff and Vale University Health Board in 2024. This included pre-existing

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Improving the number of inpatient falls by introducing inpatient falls risk assessment by doctors in geriatric wards.

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Mohammed Jamali, Phyu Phyu Thant, Siddique Adnan, Abdelmoniem Elmustafa, Thayapary Sivagnanam, Shaha Pennadam Sheriff and Dissanayake Paranathala
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Introduction Inpatient falls remain a major healthcare challenge, with an average rate of 6.6 per 1,000 occupied bed-days in NHS England and Wales hospitals. Prevention of falls during hospital stay based on identifying and managing the modifiable risks are challenging. Multifactorial falls risk assessment and prevention action plan (MFRA FPAP) is a proforma booklet adopted by ABUHB. Methodology The initial QIP (2022–2024) revealed incomplete and poor-quality MFRA. Falls champions were introduced for a period of time, it showed an improvement, but was not sustained. Due to a rise in in-patient

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Quality Improvement Project on Collateral History Taking For Geriatric Patients at a District General Hospital in South Wales

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Dr Janice Saji James, Dr Hindol Dasgupta, Dr Anita Parbhoo, Dr Taofekaat Ali, Dr Ban Allami
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Background and Objectives: Knowledge of social history and functional baseline is of paramount importance in Geriatric Medicine. Often a lack of adequate history leads to poor treatment outcomes in patients with advanced frailty. At our hospital, we have tried to identify the possible areas of improvement in collateral history documentation and designed a short and objective proforma that allows any doctor to take a detailed collateral history for geriatric patients. Methods: Data was collected retrospectively from notes of 30 patients in the Geriatric Medicine wards. This data was compared
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Silent Epidemic Undermining healthy Ageing

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N Salahudeen1, K Dineshkumar1, E B Peter1,K Bell
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Introduction Sarcopenia, a progressive and generalised skeletal muscle disorder involving the accelerated loss of muscle mass and function, is a significant geriatric syndrome associated with numerous adverse health outcomes, including increased falls, frailty, disability, hospitalisations, and mortality. Despite its high prevalence, particularly in older adults, sarcopenia often remains under diagnosed in routine clinical practice, especially in outpatient settings where early detection and intervention are crucial for preventing progression and improving patient quality of life. Method 1

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Frailty Nexus: Community of practice for frailty researchers and healthcare professionals

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B Logan1, A Young1, K Ludlow1, D Ward1, L Shafiee Hanjani1, N Reid1, RE Hubbard1
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Background: There has been success in implementing frailty education for healthcare professionals, but there remains a need to improve the knowledge and skills of researchers and healthcare professionals to develop, implement and evaluate frailty-focused research. This paper describes how the Australian Frailty Network developed and evaluated a virtual community of practice (VCOP), a proven model for fostering knowledge mobilisation, to support researchers and healthcare professionals in advancing frailty research and practice in Australia. Methods: A survey of prospective members sought to

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Atypical Legionella pneumonia in Geriatric Practice: Diagnostic complexity and domestic hot tub as source of infection.

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S Saha1, N Haddad2
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Background: Legionnaires’ disease, a form of atypical pneumonia caused by Legionella pneumophila, can present without respiratory symptoms, particularly in elderly patients with multiple comorbidities. While commonly associated with contaminated water sources and travel-related exposure, community-acquired cases without typical respiratory symptoms can be easily overlooked. Early recognition and targeted therapy are crucial to reduce morbidity and mortality. Case Presentation:A 78-year-old male, ex-smoker, with known COPD, Chronic kidney Disease, non-alcoholic fatty liver disease and
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Deep Vein Thrombosis Data Analysis

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Asad Hameed, Stuart Deoraj
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Background: At Epsom and St. Helier, patients are referred to the SDEC (Same Day Emergency Care) Pathway for the organisation of an Ultrasound Doppler of their lower limbs based on their presentation to Accident and Emergency with lower limb swelling, pain, and an elevated D-Dimer. This has resulted in inundation of a dedicated ultrasound service, with wait times for scan up to 10 days. Aim: To review the DVT Pathway of outpatient referrals to the Medical Assessment Unit (SDEC) at St. Helier Hospital, To audit the outcome of DVT referrals to the SDEC department from Accident and Emergency, and
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Implementing a care home-specific falls service in Lambeth and Southwark

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H Hubbard1; A Boswall1; F Rashid1; L Feldiorean1; J Hall1; K Bradfield1; C Ingram1; J Whitney23;
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Introduction: Falls are common in people living in care homes (CHs). London Ambulance Service (LAS) data indicated four out of the ten London CHs with the highest conveyance to hospital were in Lambeth and Southwark. Secondary care and community services were unable to provide prompt consultation and address educational needs of staff required to prevent and manage CH falls. Method: The Lambeth and Southwark CH Falls Prevention group was established in 2022 by local care partnerships to explore ways to improve the approach to falls. Following an audit of falls-related service gaps, a Care Home

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An overview of the Dementia UK Consultant Admiral Nurse service supporting families affected by frailty and dementia

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Kerry Lyons1, Melissa Grundy2
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Abstract Content: Introduction: Emerging and increasing frailty often goes unidentified, and families living with dementia and frailty are missing vital opportunities to receive the right support at the right time. People living with frailty are less able to adapt to stress factors such as acute illness, injury, or changes in their environment, personal or social circumstances, leading to adverse health outcomes and an earlier loss of independence. Method: We have developed a unique and innovative National frailty Consultant Admiral Nurse service to address this concern. This service was

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